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FORM NO- ……………….PREVIOUS STUDENT CODE(DCF)…………………………..
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RAJAPUR DAKSHINBARI HIGH SCHOOL (H.S.) INDEX NO. – F1-279,INSTITUTION CODE(H.S) - 06366 Vill. – DAKSHINBARI, P.O. –NONAKUNDU, Dist. – HOWRAH, Pin – 711405, Ph. 9163780214(T.I.C) Ph – 9748949044 (PRESIDENT OF M.C)Email: rajapurdhs@gmail.com
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APPLICATION FORM FOR ADMISSION TO CLASS XI SESSION 20…...
1. NAME OF THE STUDENT (BLOCK LETTER)……………………………………………………………………
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RECENT PASSPORT SIZE PHOTO |
2. FATHER’S NAME :-……………………………………………………………………………
3. MOTHER’S NAME:-……………………………………………………………………………
4. GURDIAN’S NAME:-……………………………………………………………………………
5.ADDRESS:…………………………………………………………………………………………………………
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6. STUDENT’S DATE OF BIRTH (AS PER M.P. ADMIT):-…………………………. …………………………………………
7. MOBILE NO:- 1.……….………………………………..………………….2.…………………………………..…………………
8. STUDENT’S AADHAAR NUMBER :- …………………………………………………………………………………………….
9. SOCIAL CATEGORY :- (GENERAL/SC/ST/OBC-A/ OBC-B) …………………………SUB CASTE…………………..
10. WHEATHER DIFFERENTLY ABLE ? …………………….TYPE OF DISABILITY……………………………………………
11. WHEATHER BELONG TO BPL ? (YES/NO) …………………………………………….
12. LAST ATTENDED INSTITUTION …………………………………………………………………………………………….
13. ROLL NO OF MADHYAMIK PARIKSHA …………………………………………………….
14. REGISTRATION NO OF MADHYAMIK PARIKSHA …………………………………………………….
15. MARKS OBTAINED IN MADHYAMIK PARIKSHA :-
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SUBJECTS |
BENGALI |
ENGLISH |
HISTORY |
GEOGRAPHY |
MATHEMATICS |
PH. SCIENCE |
LIFE SCIENCE |
TOTAL |
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WRITTEN |
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IFE |
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TOTAL |
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16. PERCENTAGE OF MARKS OBTAINED IN MADHYAMIK PARIKSHA :-…………………………………………
17. NATIONALITY ……………………….18. RELIGION …………………………19. SEX- (M/F)………………….
20. SUBJECT OFFERED :- 1. ENVS 2. HISTORY 3. PHILOSOPHY 4. SANSKRIT 5. EDUCATION
17. SUBJECT COMBINATIONS OF CLASS XI:-
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LANGUAGE-1 |
LANGUAGE-1 |
SUBJECT-1 |
SUBJECT-2 |
SUBJECT-3 |
SUBJECT-4 |
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BENGALI |
ENGLISH |
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DECLARATION OF THE APPLICANT :-
I do hereby declare that all the statements made in the application are true and correct, if any of those found not to be true and after admission in the school if I violate any rules and regulations my admission will be liable to be cancelled.
Date………………………………… Signature of the applicant (full) :………….………………………………………………….
DECLARATION OF THE GURDIAN :-
I do hereby declare that my son/ daughter will obey disciplines , rules and regulations of the school. if my son/ daughter is found to violate disciplines / rules and regulations I will remove him/her from the school.
Date………………………………… Signature of the guardian (full) :-………….………………………………………………….